Laparoscopy is a general term referring to the use of a laparoscope, a device consisting of a tube and an optical system, for exploring the peritoneal cavity or performing surgical procedures. A laparoscope is a specific type of endoscope, which is a device for viewing a body cavity or organ through a natural orifice or through a surgical incision.
The equipment used in laparoscopy normally includes a trocar. A trocar is a hollow steel tube with a pyramid-shaped point at one end. The trocar will fit into a sleeve or cannula, which has a valve at the other end. The equipment used in a laparoscopy also includes an optical system of lenses and eyepieces for viewing, a fiberoptic light system for lighting the operative field, a gas insufflation apparatus to inflate the peritoneal cavity so as to enhance the surgeon's ability to see inside the cavity, and other attachments such as scissors, forceps, electrodes, and electrocautery devices.
Laparoscopy can be performed under general anesthesia or under local anesthesia with mild sedation. Since diagnostic laparoscopy involves extensive manipulation of tender pelvic organs, local anesthesia is not recommended for those procedures. After the patient is positioned in the stirrups, the table is tilted slightly to place the patient in a modified Trendelenburg position. A clear gas, either carbon dioxide or nitrous oxide, is then pumped into the peritoneal cavity through a special needle. The needle is then removed and the incision is enlarged to about one centimeter. The trocar and sleeve are then inserted through the enlarged incision, the trocar is removed, and the laparoscope itself, along with its attachments, is inserted through the sleeve. Sometimes a two-incision technique is used in order to fully visualize the entire abdominal area or to insert a second instrument, such as a retractor. After the procedure, the instruments are removed from the sleeve, and the valve on the sleeve is opened to let the gas out.
In those situations in which a retractor used in the two-incision approach to laparoscopy, the retractor will be inserted through another sleeve in the abdominal cavity. One of the common problems associated with the use of retractors in laparoscopy is the fact that the end of the retractor, which enters the abdominal cavity, is generally smaller than the diameter of the sleeve through which it passes. As such, the retractor has a relatively small surface area within the abdominal cavity that must be used for the manipulation of organs within the abdomen. Since the retractors must be of relatively small diameter, in order to pass through the sleeve, there is the general inability to properly manipulate the organs so as to enhance the ability to carry out the viewing process. Many times, surgeons are generally apprehensive to the use of such retractors during the surgery. The small diameter retractor can potentially puncture the bowels, or other internal organs, during the manipulation within the cavity.
The ability to manipulate the organs during the two-incision process of laparoscopy greatly enhances the ability of the surgeon to properly tend to the needs of the patient. Unfortunately, many retractors, which are used in the surgical procedure, are rigid implements that can only carry out one-dimensional movements within the abdominal cavity. Since the ends of the retractors, within the cavity, are fixed, the only way to manipulate the end is to manipulate the retractor, and the sleeve, within the incision. This has been found to be ineffective for the needs of laparoscopy.
It is an object of the present invention to provide a surgical retractor assembly for use in laparoscopy procedures.
It is another object of the present invention to provide a surgical retractor assembly that provides a maximum of surface area within the abdominal cavity.
It is another object of the present invention to provide a surgical retractor that is remotely actuable so as to enhance the ability to manipulate internal organs.
It is still a further object of the present invention to provide a surgical retractor assembly that is easy to use, and adaptable to a wide variety of situations.
These and other objects and advantages of the present invention will become apparent from a reading of the attached specification and appended claims.